In the 1990s, the Centers for Disease Control (CDC) named water fluoridation one of the top 10 public health accomplishments of the 20th century (For the CDC’s 10 greatest public health achievements, see footnote 1).
Why is water fluoridation so important?
According to the American Dental Association, fluoride in water can help reduce tooth decay by over 25% in adults and children. As a result of these findings, communities worldwide began adding fluoride to their water, which they continue today.
Fun fact: What Midwestern city in the United States was the first to add fluoride to water? (See footnote 2 for the answer.)
Figures from CDC’s National Water Fluoridation Statistics show that as of 2018 (the most recent figures available), around 73% of municipal water systems deliver fluoridated water to about 63% of Americans.
Here we discuss a few basic questions that people ask about fluoride. First, what does fluoride do, and is fluoride safe? Second, where can you get natural fluoride or fluoride supplements?
What Does Fluoride Do?
When used in oral care, fluoride makes teeth resistant to demineralization when acids from food or drinks attack tooth enamel. Fluoride further aids in remineralization, which is the repair of tooth surfaces from demineralization damage. In essence, fluoride protects and fortifies our teeth.
Where Do You Get Fluoride?
Fluoride comes from fluorine, a naturally occurring mineral. We get fluoride in two major ways: topically through dental health products like toothpaste, mouthwash, and dental treatments; and orally through drinking water and eating some foods.
Local water supply
The majority of U.S. public water systems contain fluoride. To find out about your state’s water system, use the online tool “Find Water System Information” from the CDC. To search, simply select your state, county, and city from the filters.
If you rely on well water, reach out to your local health department to test your water to see what minerals it contains. The CDC recommendations call for 0.7 milligrams of fluoride per liter of water.
With many consumers opting for water-filtration systems or bottled water for their homes and businesses, they are likely missing the benefits of fluoride. People have valid reasons for choosing bottled water: better taste and no chemicals and minerals in their drinking water.
If you are thinking about adding a filtration system to address your concerns about the water quality or flavor in your home or business, talk about the options for preserving fluoride with your installer or manufacturer. Here is a look at what the ADA says about the four most common water treatments and their effects on fluoridated water:
- Reverse osmosis: Removes fluoride.
- Water softeners: Do not remove fluoride.
- Distillation process: Can remove a substantial amount of fluoride.
- Carbon water filters: Most do not remove fluoride, but some do so check with the manufacturer.
Consumers who drink filtered or bottled water have several options for ensuring they consume adequate fluoride levels to support and promote oral health.
Fluoride toothpaste and mouthwashes
Perhaps the number one oral health care product that contains fluoride is toothpaste. Even higher-end teeth-brightening products come fluoride enriched, which can protect your teeth and remove stains. Many manufacturers of oral care products also add fluoride to mouthwashes and rinses.
Fluoride additives in toothpaste and oral rinses are safe for use and effectively prevent tooth decay and advance remineralization. However, rumors and myths swirl that have consumers, especially parents, worried about the potential for overdosing on fluoride.
Fluorosis occurs when a person consumes too much fluoride. Parents should watch their children brush their teeth to make sure they don’t use too much toothpaste or swallow it.
Medical News Today suggests the following parts per million of fluoride for children: up to age 3: 1,000 ppm and 1,350 to 1,500 ppm for children 3 to 5 years of age.
This information is not medical advice. You should always seek guidance from medical professionals, including your pediatrician, primary care doctor, and dentist.
Dentist-applied fluoride treatments
Some dentists recommend topical fluoride treatments every few months. Dentist-applied fluoride treatments come as gels, pastes, foams, and varnishes — and can cost you $10 to $30 or more. Inadequate oral hygiene is one of the top reasons dentists recommend a fluoride treatment, but there are many other reasons, according to the ADA. Your dentist might advise fluoride treatment for you every few months if you have:
- Recessed gums and exposed dental roots
- Fillings, crowns, or restorations
- Dry mouth
- A history of alcohol or drug use or abuse
- A poor diet or eating disorder
- Received radiation therapy in the head or neck area
Foods that contain fluoride
Foods containing the highest fluoride levels are shellfish and ocean fish due to the amount of naturally occurring fluoride in ocean water. Other foods that contain fluoride include breakfast cereals like oatmeal, raisins, and black tea.
You can also increase the amount of fluoride in your food by cooking it in fluoridated water. If you feed infant formula to your baby, you should ask your pediatrician for their recommendation on the best water to use and appropriate fluoride levels.
Visit the USDA’s National Fluoride Database of Selected Beverages and Foods for a complete list of foods that contain fluoride.
Fluoride supplements
Dentists might prescribe fluoride supplements from a local pharmacy in areas where fluoridated water is unavailable and children are at high risk for tooth decay. Fluoride supplements should only be taken as recommended by your dentist or primary care physician.
Busting Myths About Fluoride
No doubt, the internet, and a good controversy go hand-in-hand. Fluoridated water is froth with myths and rumors. The ADA’s Fluoridation Facts (Practical Guide Series) states:
- Fluoridated water is safe for use in infant formula (unless otherwise recommended by your pediatrician or dentist).
- Fluoride is not toxic.
- There is no connection to drinking fluoridated (at recommended levels) water.
- Fluoridated water does not cause bone cancer (osteosarcoma).
- No scientific evidence exists to support that drinking optimally fluoridated water while pregnant leads to congenital disabilities.
- Drinking fluoridated water does not increase a person’s risk for cardiovascular diseases.
Trust only scientific research and ignore rumors that lack credible sources. That means do not believe everything you read about fluoridated water on social media. Consult your medical and dental professionals with questions or concerns about your oral care.
Footnotes
1- For the trivia-curious, the CDC’s 10 greatest public health achievements, in addition to community water fluoridation in the 20th century, are: vaccinations, motor vehicle safety, safer workplaces, control of infectious diseases, the decline in deaths from coronary heart disease, and stroke, safer and healthier foods, healthier mothers and babies, family planning, and recognition of tobacco use as a health hazard.
2- The first city to add fluoride to the public water supply was Grand Rapids, Michigan, in 1945, according to the CDC.
Sources
ADA, Fluoridation Facts (Practical Guide Series), 2018, accessed 2021 Aug. 30.
CDC, Ten Great Public Health Achievements — United States, 1900-1999, MMWR Weekly, 1999 April 2, accessed 2021 Aug. 30.
NIH, Fluoride Fact Sheet for Health Professionals, Office of Dietary Supplements, 2021 March 29, accessed 2021 Aug. 30.
Medical News Today, Why Do We Have Fluoride in Our Drinking Water? 2018 Feb. 21, accessed 2021 Aug. 30.
NIH, Fluoridated Water (Common Cancer Myths and Misconceptions), National Cancer Institute, 2017 May 15, accessed 2021 Aug. 31.
